Addressing the enduring challenge of evaluating traditional Chinese medicines (TCMs), the integrated evidence chain-based effectiveness evaluation of TCMs (Eff-iEC) has emerged. This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines (CPMs), including Biejiajian Pill (BP), Dahuang Zhechong Pill (DZP), Biejia Ruangan Compound (BRC), Fuzheng Huayu Capsule (FHC), Anluo Huaxian Pill (AHP), and Heluo Shugan Capsule (HSC), using both Eff-iEC and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents. Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system, while the assessments for others varied. Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs, exhibiting superior evaluative capabilities. By breaking through the conventional pattern of TCMs effectiveness evaluation, Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs, providing a coherent methodology for clinical decision-making, new drug evaluations, and health policy formulation.

Objective:To investigate the additional value of 99Tc m-hydrazinonicotinamide (HYNIC)-Tyr3-octreotide (TOC) SPECT/CT imaging in the diagnosis and treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Methods:A total of 54 patients (28 males and 26 females, age: (52.6±11.7) years) who underwent enhanced CT (MR) and 99Tc m-HYNIC-TOC SPECT/CT in People′s Hospital of Zhengzhou University between December 2017 and June 2023 were analyzed retrospectively. Surgical pathology or biopsy was the gold standard of patients′ diagnosis (primary tumors), and comprehensive evaluation based on pathology, imaging and follow-up results was used as the diagnostic criteria of lesions. McNemar χ2 test was used to compare the diagnostic efficacy of different imaging methods. Results:Pathological results showed that 43 of the 54 patients were with GEP-NETs and 11 were with non-neuroendocrine tumors (NETs). The sensitivities of enhanced CT and enhanced MR in the diagnosis of patients with GEP-NETs were 65.1%(28/43) and 60.0%(15/25) respectively, which increased to 93.0%(40/43) and 92.0%(23/25) with the addition of 99Tc m-HYNIC-TOC imaging ( χ2 values: 8.64, 4.90, P values: 0.002, 0.021). There were 22 and 15 patients showing atypical enhancement on enhanced CT and enhanced MR respectively. The sensitivities of these two methods for GEP-NETs in patients with atypical enhancement were 54.5%(12/22) and 8/15 respectively, which increased to 95.5%(21/22) and 14/15 with the addition of 99Tc m-HYNIC-TOC imaging ( χ2 values: 5.82, 4.17, P values: 0.012, 0.031). Compared with enhanced CT, the detection rates of liver and bone metastatic lesions were improved significantly from 90.8%(158/174) and 55.2%(32/58) to 96.6%(168/174) and 87.9%(51/58) with the addition of 99Tc m-HYNIC-TOC imaging ( χ2 values: 5.79, 9.82, P values: 0.013, 0.001). Compared with enhanced MR, the detection rate of bone metastases was improved significantly from 56.0%(14/25) to 88.0%(22/25) with the addition of 99Tc m-HYNIC-TOC imaging ( χ2=4.08, P=0.039). After 99Tc m-HYNIC-TOC imaging, stages were changed in 7.0%(3/43) of patients and a greater number or extent of metastases were detected in 11.6%(5/43) of patients. 99Tc m-HYNIC-TOC imaging detected additional recurrent or metastatic lesions in 40.0%(8/20) of patients during follow-up compared to enhanced CT. Conclusion:99Tc m-HYNIC-TOC imaging can provide an added value for diagnosing GEP-NETs with atypically enhanced CT(MR), and in the detection of liver metastasis and early bone metastasis, thus helping the optimization of clinical treatment strategies.

Objective:To analyze the clinical characteristics of poisoning inpatients in the first affiliated hospital of chongqing medical and pharmaceutied hospital, and to provide basis for improving the level of prevention, control, diagnosis and treatment of regional poisoning.Methods:In January 2024, using the HIS medical record system of The First Affiliated Hospital of Chongqing Medical and Pharmeceutical College, we collected the clinical data of poisoning inpatients admitted to our hospital from 2018 to 2023. The data of sex, age, time of poisoning, poison species, poisoning cause, poisoning route, season, treatment and prognosis were analyzed.Results:A total of 972 patients were enrolled, among whom 71.71% (697/972) were young and middle-aged adults, with a higher incidence in summer. Chemical poisoning accounted for 53.61% (521/972) , followed by pesticide poisoning and mixed poisoning in the second and third places. The overall detection rate of toxins was 58.23% (566/972) . The number of domestic poisonings increased year by year, while occupational poisonings decreased year by year, with statistically significant differences ( P<0.05) . The overall cure and improvement rate was 97.22% (945/972) , and the cure and improvement rate of pesticide poisoning was the lowest at 90.23% (120/133) . Factors such as age >60 years, intentional exposure to toxins, pesticide exposure, gastric lavage, blood purification, and length of hospital stay affected the prognosis of patients ( P<0.05) . Conclusion:Health education should be actively promoted, toxin control should be strengthened, scientific and reasonable prevention and control measures as well as treatment methods should be adopted to reduce the incidence and mortality of poisoning.

Objective To develop a precise method for analyzing urinary peptides based on electromembrane extraction(EME)combined with liquid chromatography-tandem mass spectrometry(LC-MS/MS),and to evaluate its potential applicability in tumor biomarker screening.Methods A total of 15 disease-associated peptides were selected as the target analytes.A supported liquid membrane(SLM)composed of n-octanol containing 5%di(2-ethylhexyl)phosphate was employed,with the donor phase being a 1∶1 mixture of urine and 100 mmol/L formic acid and urine,and the acceptor phase being 20 mmol/L formic acid containing 50%dimethyl sulfoxide(DMSO).After EME at 40 V for 15 min,the acceptor phase solution was analyzed by LC-MS/MS.Subsequently,the method,EME combined with LC-MS/MS(EME-LC-MS/MS),was preliminarily validated utilizing urine samples from 12 healthy controls and 7 patients with urinary system tumors.Results All 15 peptides exhibited excellent linearity in the range of 0.1-100.0 ng/mL(r≥0.995),with the limits of detection(LODs)being 0.01-0.50 ng/mL and the limits of quantification(LOQs)being 0.03-1.50 ng/mL.The spiked recoveries ranged from 21.0%to 71.2%,with relative standard deviations(RSDs)of 0.8%-20.0%(n=3).Small-sample analysis of clinical specimens revealed that the concentration of bradykinin 1-5 in the urine were significantly higher in tumor patients(median:0.65 ng/mL)than that in healthy controls(median:0.37 ng/mL)(P<0.05),suggesting its potential as a specific biomarker for urinary system tumors.Conclusion The EME-LC-MS/MS method established in the study features simplicity,high efficiency,and high sensitivity,enabling precise determination of trace-level peptides in urine samples.Moreover,this approach provides a reliable methodological basis for disease biomarker screening and promotes the clinical application of electromembrane extraction.

Allergic rhinitis(AR)is the most common airway allergic diseases.Basophils are the classical effector cells in allergy,including AR:Both IgE and non-IgE mediated methods can activate basophils during allergic reactions and induce basophils to release various inflammatory mediators,which is accompanied by changes in the expression of multiple membrane proteins,and ulti-mately leading to the clinical manifestations of allergic diseases.IL-18 may be involved in the pathogenesis of AR by directly inducing basophil activation and inflammation response via binding to its receptor IL-18Rα.Nevertheless,the binding of IL-37b to IL-18Rα initiates the downstream anti-inflammatory signals,thus inhibiting inflammation reaction in AR.Therefore,understanding the role and mechanism of IL-18 and IL-37b in the activation of blood basophils of AR patients is of great significance for the pathogenesis,treat-ment of AR and the development of related biological agents.

Objective:To investigate the effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in blood CD4+Th17 cells of patients with allergic rhinitis and asthma syndrome(ARA)and plasma levels of IL-17A and IL-17F in ARA patients.Methods:ARA patients(n=25)and healthy volunteers(n=22)in the First Affiliated Hospital of Jinzhou Medical University and Henan Provincial People's Hospital were recruited,and blood samples of the subjects were collected.Proportions of CD4+Th17 cells,and effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in Th17 cells were determined by flow cytometry.Levels of IL-17A and IL-17F were examined by Bioplex system.Correlation between levels of free plasma free IL-18(fIL-18)and IL-17A,and per-centage of Th17 cells was further analyzed.Results:Proportion of IL-18+cells in Th17 cells was increased in ARA patients by 26.0%(P<0.01),and house dust mite allergen induced 1.22-fold elevation in expression of IL-18 in Th17 cells(P<0.05).In addition,Arte-misiae sieversiana wild pollen allergen enhanced expressions of IL-18 and IL-18Rα in Th17 cells of ARA patients(P<0.05).Plasma levels of IL-17A and IL-17F were increased by 2.2 and 1.1 folds,respectively(P<0.05)in ARA patients,and they correlated well with other(R=0.712,P<0.01).Moreover,the increased level of fIL-18 was moderately correlated with the increased level of IL-17A and the elevated proportion of Th17 cells in ARA patients(r=0.607,r=0.652,P<0.05).Conclusion:The increased plasma fIL-18 in ARA patients may be derived from Th17 cells.Allergens may be involved in pathogenesis of ARA by inducing elevated IL-18 and IL-18Rα expressions in Th17 cells.

Objective:To analyze the clinical characteristics of poisoning inpatients in the first affiliated hospital of chongqing medical and pharmaceutied hospital, and to provide basis for improving the level of prevention, control, diagnosis and treatment of regional poisoning.Methods:In January 2024, using the HIS medical record system of The First Affiliated Hospital of Chongqing Medical and Pharmeceutical College, we collected the clinical data of poisoning inpatients admitted to our hospital from 2018 to 2023. The data of sex, age, time of poisoning, poison species, poisoning cause, poisoning route, season, treatment and prognosis were analyzed.Results:A total of 972 patients were enrolled, among whom 71.71% (697/972) were young and middle-aged adults, with a higher incidence in summer. Chemical poisoning accounted for 53.61% (521/972) , followed by pesticide poisoning and mixed poisoning in the second and third places. The overall detection rate of toxins was 58.23% (566/972) . The number of domestic poisonings increased year by year, while occupational poisonings decreased year by year, with statistically significant differences ( P<0.05) . The overall cure and improvement rate was 97.22% (945/972) , and the cure and improvement rate of pesticide poisoning was the lowest at 90.23% (120/133) . Factors such as age >60 years, intentional exposure to toxins, pesticide exposure, gastric lavage, blood purification, and length of hospital stay affected the prognosis of patients ( P<0.05) . Conclusion:Health education should be actively promoted, toxin control should be strengthened, scientific and reasonable prevention and control measures as well as treatment methods should be adopted to reduce the incidence and mortality of poisoning.

Objective:To investigate the effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in blood CD4+Th17 cells of patients with allergic rhinitis and asthma syndrome(ARA)and plasma levels of IL-17A and IL-17F in ARA patients.Methods:ARA patients(n=25)and healthy volunteers(n=22)in the First Affiliated Hospital of Jinzhou Medical University and Henan Provincial People's Hospital were recruited,and blood samples of the subjects were collected.Proportions of CD4+Th17 cells,and effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in Th17 cells were determined by flow cytometry.Levels of IL-17A and IL-17F were examined by Bioplex system.Correlation between levels of free plasma free IL-18(fIL-18)and IL-17A,and per-centage of Th17 cells was further analyzed.Results:Proportion of IL-18+cells in Th17 cells was increased in ARA patients by 26.0%(P<0.01),and house dust mite allergen induced 1.22-fold elevation in expression of IL-18 in Th17 cells(P<0.05).In addition,Arte-misiae sieversiana wild pollen allergen enhanced expressions of IL-18 and IL-18Rα in Th17 cells of ARA patients(P<0.05).Plasma levels of IL-17A and IL-17F were increased by 2.2 and 1.1 folds,respectively(P<0.05)in ARA patients,and they correlated well with other(R=0.712,P<0.01).Moreover,the increased level of fIL-18 was moderately correlated with the increased level of IL-17A and the elevated proportion of Th17 cells in ARA patients(r=0.607,r=0.652,P<0.05).Conclusion:The increased plasma fIL-18 in ARA patients may be derived from Th17 cells.Allergens may be involved in pathogenesis of ARA by inducing elevated IL-18 and IL-18Rα expressions in Th17 cells.